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2009
CMS to Delete 90-Day Remote Monitoring Pacemaker and ICD Edits Retroactive to January 1 (04/01/2009) — On April 1, 2009, the Centers for Medicare and Medicaid Services (CMS) will retroactively reverse a National Correct Coding Initiative (NCCI) edit implemented on January 1, 2009 (Version 15.0) that prohibited billing CPT code 93294 with 93296 and 93295 with 93296. Providers who received claim denials based on the edits prior to April 1 may resubmit or appeal their claims. Learn more »
CMS Responds to Request to Delete NCCI Edits for 93296 A major error with two of the finalized National Correct Coding Initiative (NCCI) edits published for the new device monitoring services effective January 1, 2009 (Version 15.0 )was discovered and immediately brought to the attention of the Centers of Medicare and Medicaid Services (CMS) by the Heart Rhythm Society and the American College of Cardiology. CMS has stated that it will delete the pair edits in Version 15.1, the next quarterly update scheduled for implementation on April 1, 2009. The deletion will be retroactive to the January 1 implementation date. Learn more »
NCCI Challenges Successful (01/21/2009) — The Heart Rhythm Society succeeded once again in its objection to proposed National Correct Coding Initiative (NCCI) edits — scheduled to take effect on April 1, 2009 (Version 15.1) — that would have discontinued modifier usage for billing of an insertion or replacement of a pacemaker or ICD pulse generator (33212-33214, 33240 and 33249) performed on the same day as a device interrogation and/or programming service (93279-93284 and 93288-93289). Learn more »
2008
The Heart Rhythm Society Successfully Advocates To Maintain Reimbursement for Comprehensive EP Evaluation Services (11/03/2008) — The Heart Rhythm Society, in conjunction with the American College of Cardiology (ACC), seem to be headed for a significant victory over the AMA CPT/RUC Joint Workgroup in maintaining separate reimbursement for comprehensive EP study codes 93620 and 93621. Learn more»
CMS to Test Use of Bundled Payments for Both Hospitals and Physician Services (05/16/2008) — The Centers for Medicare & Medicaid Services (CMS) has announced a new Acute Care Episode (ACE) demonstration for hospitals, designed to align financial incentives across providers and offer flexibility to hospitals and physicians by bundling all related inpatient services into an “episode of care.” The ACE demonstration is scheduled to begin operation in January 2009. Learn more »
MedPAC Discusses Bundling Services Related to Selected Procedures Performed in Hospital (03/13/2008)— On March 5-6, 2008, the Medicare Payment Advisory Commission (MedPAC) met in Washington, D.C. to discuss ways to change Medicare payment for an episode of care surrounding a hospitalization as a way to encourage greater “systemness” in health care delivery and improve the accountability for cost and quality of care. Learn more »
Advisory Panel on Ambulatory Payment Classification Groups (APC) Recommends CMS Reinstate Separate Payment for Intracardiac Echocardiography (ICE) (03/05/2008) — On March 5, the Advisory Panel on Ambulatory Payment Classification Groups (APC) met at CMS headquarters in Baltimore, Maryland. The Panel recommended that CMS reinstate separate payment for intracardiac echocardiography (ICE), CPT code 93662. The rationale that guided this decision is that packaging payment for this low volume service financially rewards hospitals that do not use ICE. Learn more »
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